Organization
ADVANCED HEALTH CARE PHYSICAL MEDICINE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HUI LIN O'CONNOR (OFFICE MANAGER)
(386) 673-2000
Entity
Organization
Contact information
Practice address
801 W GRANADA BLVD, SUITE 101, ORMOND BEACH, FL 32174-8114
(386) 673-2000
(386) 673-2002
Mailing address
801 W GRANADA BLVD, SUITE 101, ORMOND BEACH, FL 32174-8114
(386) 673-2000
(386) 673-2002
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME60233
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GH417A
MEDICAREPTAN
FL
Enumeration date
03/20/2012
Last updated
03/27/2013
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